1. Field of the Invention
The present invention relates to nasal cannula apparatus for use by patients, desiring a comfortable arrangement. The nasal cannula apparatus is particularly suited for long-term oxygen users, for extended wear in both standing, resting and supine positions. The nasal cannula apparatus has headgear and retainers for holding the gas supply tubes, which are adjustable to allow fast and easy adjustment to size. The headgear and retainers allow the cannula tubes to be held in a position which prevents skin discomfort, irritation, blisters, abrasions, pressure sores and other injuries and promotes healing of such irritation, injuries and sores.
2. Description of the Prior Art
There are a number of persons requiring supplemental oxygen such as after surgery to aid in the healing process, and persons having lungs of limited capacity due to disease or lung damage which require supplemental oxygen to assist in everyday life. These people having respiratory problems are typically assisted in breathing by providing a gas source, which provides pressurized ambient or oxygen enriched air to the lungs of the patient via a nasal cannula. A typical arrangement for a cannula apparatus is illustrated in U.S. Pat. No. 3,726,275, Jackson et al., entitled “Nasal Cannulae”. The nasal cannula comprises essentially a nasal assembly, or nosepiece, with a hollow main body having two directed orifices near or in a patient nostrils. Typically, the orifices consist of nasal extension tubes extending upwardly from a main body portion and gas is supplied through supply tubes to the main body, which acts as a distributing manifold. Commonly, the cannula nosepiece is held in place by extending the gas supply tubes from the patient's nasal area to behind the patient's ears. The flexible tubes are bent downward behind the ears to run along the jaw area, and are held in place by an adjustable slip loop or a cinch tightened below the chin to hold the nosepiece in place. Oxygen or other gas flows through the tubes to the two orifices, thereby supplying the patient with pressurized ambient or oxygen enriched air.
While being one of the most convenient methods known to date for supplying a patient with a gas enriched environment, existing nasal cannulae suffer a major drawback: the positioning of the tubes around the ears for support is uncomfortable and can cause the patient chaffing and pain. Additionally, existing nasal cannulae are prone to falling off the patient's face. Patients regularly find that body movement, especially during sleep, causes the cannula to dislocate, depriving the patient of the needed oxygen enrichment. Accidental removal of the cannula can also cause severe discomfort to the patient and in certain cases may even be life threatening.
As a means of preventing movement of the cannula from within the nasal passages of the patient, numerous devices are known to the prior art for stabilizing the cannula with respect to the patient. Some devices employ the gas supply tubes that supply air from the respirator to the cannula for holding the cannula in place. For example, in U.S. Pat. No. 3,915,173 to Brekke, a cannula assembly is shown wherein portions of the gas supply tubes are seated on the bridge of the patient's nose. In U.S. Pat. No. 2,693,800, the gas supply tubes are passed over the ears of the patient.
U.S. Pat. No. 2,168,705, Francisco et al., entitled “Nasal Inhaler”, discloses a support for cannula tubes having temples which clasp behind the wearer's ears and include nose pads of the type used with eyeglasses. The use of temples and nose pads also makes this arrangement uncomfortable and not well suited for use while the wearer is sleeping.
U.S. Pat. No. 2,259,817, Hawkins, entitled “Adjustable Head Attachment for Oxygen Tubes” discloses a support for cannula tubes having an adjustable temple band and an adjustable crown band These bands and associated buckles, together with the obtrusive nose portion of the cannula tube also make this arrangement uncomfortable and unsuitable for sleeping.
U.S. Pat. No. 4,559,941, Timmons et al, entitled “Eyeglass Frame and Nasal Cannula Assembly”, discloses a cannula apparatus which supports and substantially conceals the cannula tubes by eyeglass frames. That arrangement is not well suited for use while the wearer is sleeping. In addition, some individuals who do not wear glasses for reasons of vision find glasses uncomfortable or awkward and would prefer another nasal cannula arrangement.
U.S. Pat. No. 4,808,160 to Timmons, et al discloses a “Nasal Cannula Apparatus” comprising a headband with a cannula junction thereon from which nasal tubes extend downwardly across the face on either side of the nose, and curve up into the nostrils. This arrangement is uncomfortable against the face and can block or impair ones vision.
U.S. Pat. No. 4,774,946 to Ackerman, et al discloses a “Nasal and Endotracheal Tube Apparatus” for use with infants comprising bulbous nasal tubes and a headband yoke for clipping corrugated supply tubes thereto. This arrangement is uncomfortable in the nasal passages and is not compatible with standard supply tubes.
U.S. Pat. No. 4,367,735 to Dali discloses a “Nasal Cannula” with ribbed nose prongs attached to a foam base for attachment to a skullcap. The foam base, which extends across the face is bulky and can also be uncomfortable as well as obstructive.
U.S. Pat. No. 4,699,139 to Marshall, et al, U.S. Pat. No. 4,949,733 to Sampson, U.S. Pat. No. 5,400,776 to Bartholomew, and U.S. Pat. No. 6,026,811 to Settle, all teach devices that fit around the supply tubes and are placed on or around a patients ears. These devices are used to maintain a bend in a tube and/or provide padding for comfort about the ears. U.S. Pat. No. 6,434,796 to Speirs also teaches an “Oxygen Delivery Cannula Retainer, Cannula With Retainers Assembly, And Method For Retaining Cannulas” comprising a device securable about a patients ears. Although meant to provide comfort, these devices still create chaffing and discomfort due to placement about the patient's ears.
U.S. Pat. No. 5,636,630 to Miller et al., U.S. Pat. No. 4,836,200 to Clark, U.S. Pat. No. 4,422,456 to Tiep, and U.S. Pat. No. 6,298,850 to Argraves, all attempt to solve this problem. Miller et al. discloses running the tubes behind the patient head and utilizing a coupling portion contacting the back of the head, with the gas conduits passing in criss-cross manner behind the head. This arrangement suffers from several disadvantages, major amongst them is the location of both oxygen tubes behind the patient's head where they may be blocked if the head is resting thereupon. Additionally, placement of tubes behind the head is often uncomfortable to the patient.
The Clark patent utilizes a pressure-fastening strap adapted to go over the top of a user's head, onto which the flexible tubes are attached. Clark's preferred implementation is less desirable since the strap may slide over the head of the user and is liable to entangle with the patient's hair.
Tiep and Argraves disclose means for supporting the cannula in place by an elastic band that is adjustably connected to two holders each located on one of the conduits or flexible tubes. An elastic band extending behind the patient's head is secured to the tubes. A problem with these inventions is that the elastic band runs the risk of entanglement in the patient's hair.
The major problem with the cannulas and retainers of the prior art is that they rub on the face and ears of a patient under extended use. This rubbing causes discomfort, chaffing, sores and infections, particularly in elderly patients and other with heightened sensitivity such as chemotherapy patients. The retainers and pads of the prior art are also obtrusive, uncomfortable and unattractive and do not particularly alleviate the chaffing of the skin of the face and ears.
Another major problem with such prior art cannula occurs when the main oxygen delivery tube which delivers oxygen to the cannula gets snagged on an object, which happens frequently during the course of a day for a mobile person such as when carrying or pulling a portable oxygen tank or a person connected by a long main tube to a stationary oxygen concentrator located in a house or apartment. When such snagging occurs, the oxygen tubes are typically pulled downwardly such that the tension on the upper portions of the oxygen tubes is significantly increased jamming the nosepiece into the person's nose causing much discomfort to such person and potential injury to the nose, ears, and face of the person. Such snagging also causes the upper portions of the respective oxygen tubes to move upwardly towards the person's eyes partially blocking the field of view, which can be particularly hazardous while driving an automobile.
Another problem is that the retaining collars are prone to slip downwardly during cannula use such that the tension on the oxygen tubes is reduced. Such loss of tension can cause the nosepiece to fall from the person's nose and the oxygen tubes to fall from around the person's ears. This is particularly prone to occur when the person is asleep and is typically caused by tossing and turning of the person causing contact of the cannula and retaining collar against the bed. The person generally awakes when the nosepiece dislodges or falls from the person's nose due to the insufficient supply of oxygen to the person's brain, and the person must subsequently reattach the cannula. This activity disrupts the person's sleep particularly when occurring multiple times each night. If the person does not awake, potentially serious hypoxia, including permanent brain damage and death can occur due to the lack of sufficient oxygen supply to the person's brain.
Thus, there is a need for a means and method for retaining a cannula in place during use, to particularly prevent the chaffing of the ears and face, and for preventing painful tugging on the oxygen tubes jamming the nose piece into the person's nose, particularly while the person is awake and active.
It is clear therefore that a need exists for a device to secure a nasal cannula to a patient's head in a light, inexpensive, and effective manner, and doing so in a manner that will be unobtrusive to the patient. Additionally, a better solution is needed for providing user comfort in the nasal septum and other facial areas as described above. The current invention discloses such a device and method for its use.